Jimmy Deenihan (Kerry North, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise this very important matter. A serious problem has arisen in my constituency regarding cervical smear cytology. Cervical smear tests are recommended for all women aged between 20 and 65. As the national smear testing programme has not yet been rolled out to counties such as Kerry, many GPs do their own screening on a voluntary basis. The majority of GPs have been sending smears to the laboratory at the Royal College of Surgeons unit in Beaumont Hospital for the past nine years or so, where they get a very professional service, with results returned after a waiting time of six to eight weeks.

On Wednesday last, GPs received correspondence from the RCSI lab, advising that it could no longer accept smears, with immediate effect. No explanation was given, I understand. Apparently, the only alternative is to send the smears to Cork University Hospital. However, the staff in CUH are under considerable pressure and are just about coping with their current workload. They are still opening smears they received last April. Besides that, they do not accept liquid-based smears from GPs, a method used by most GPs and predominantly across Europe.

Cork University Hospital only accepts smears taken using wooden spatulas, with the sample being placed on a slide manually by the GP. As a result of the backlog of work in CUH, the staff are under so much pressure that they have not yet adopted technology to analyse liquid-based smears.

Cervical cytology is a labour-intensive job. It involves highly-trained cytologists analysing a smear through a microscope for a considerable length of time. Even if the CUH lab was equipped to do liquid smear tests, it just could not double its output overnight if all the GPs now using the RCSI had to be accommodated.

The GPs must send their patients' smears to an accredited lab which can process liquid-based smears and report on them within three months at most. They are reluctant to return to the old method of taking smears using wooden spatulas as the liquid-based method is accepted as being superior. Besides that, they are not prepared to wait seven months for the result of a smear test as this could be fatal for the patient.

The vast majority of GP smears are carried out on GMS patients. The GPs do not get paid for this work, not even for the special delivery postage. The concern of the GPs is not driven by money, but it is rather a genuine concern for the patients' health. Early diagnosis and medical intervention in many cases is the difference between the life and death of a woman with cervical cancer. Deaths are preventable and it would be a tragedy if GPs had to stop doing smear tests because they had no place to send them for analysis.

I call on the Minister, through the Minister of State, to make direct contact with Professor Brendan Drumm of the Health Service Executive to request him to make immediate provision so that Kerry GPs can have access to a modern accredited lab which can accept liquid-based smears. I am sure the Minister of State will accept that the women of Kerry, and those living in other parts of the country who depend on the RCSI unit at Beaumont Hospital, deserve this service at least.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I am taking this Adjournment debate on behalf of my colleague, the Minister for Health and Children, Deputy Harney. The laboratory of the Royal College of Surgeons in Ireland at Beaumont Hospital has decided not to continue with the testing of cervical smears referred by general practitioners in the southern and north-eastern areas. Approximately 60 practices are affected.

This laboratory is private and contracted by the HSE to conduct liquid-based testing on cervical smears sent in by general practitioners. On 9 November 2006, the HSE wrote to general practitioners in Kerry affected by the decision asking them to refer cervical smears to Cork University Hospital instead of to the Royal College of Surgeons in Ireland. General practitioners were asked to implement this change with immediate effect. These are transitional arrangements necessary to ensure that general practitioners are aware of the designated laboratories for the testing of cervical smears taken at their practices.

The director of the Irish cervical screening programme is to meet representatives of Cork University Hospital again next week. The aim of the meeting is to deal with any issues the hospital may have in covering the additional workload involved. The objective of the HSE is to improve on an ongoing basis the turnaround time for receipt of cervical test results. The programme has provided training to laboratory staff at Cork University Hospital to conduct liquid-based testing. This test is more costly than conventional testing, is more accurate and tests can be conducted more quickly. It is more efficient as it results in fewer repeat smears. This means that significantly fewer women will be asked to have a repeat test.

The executive is concerned about the unacceptable turnaround time for conventional smears in the southern area. It has decided to refer smears to two private laboratories, one of which is in the United Kingdom. Contract approval was signed earlier this week following a competitive tendering process. Arrangements are now being made to refer samples to the two laboratories. The HSE expects to have test results available commencing next month.

The issue raised by the Deputy is also relevant to cervical screening generally. The Minister wishes to see the Irish cervical screening programme rolled out nationally as soon as possible, based on an affordable model and in line with international best practice. Significant preparatory work is well under way involving the introduction of new and improved cervical tests, improved quality assurance training and the preparation of a national population register. An additional €1.3 million was made available to the HSE in 2006 to prepare for the roll out.

The Minister will shortly establish a national cancer screening service to amalgamate BreastCheck and the ICSP, to deliver both programmes on a national basis. This will maximise the expertise in both programmes, ensure improved efficiency and develop a single governance model for cancer screening. The plan is to have cervical screening managed as a national call-recall programme via effective governance structures that provide overall leadership and direction, in terms of quality assurance, accountability and value for money. All elements of the programme, call-recall, smear taking, laboratories and treatment services must be quality assured, organised and managed to deliver a single integrated service.

The Minister will request the service to ensure that the laboratory elements will be delivered in an efficient and cost effective manner that ensures high quality and good turnaround time for results.